Speaker
Terri R. Fried, MD
Section Chief, Geriatrics
Professor of Medicine
Yale School of Medicine
Attending Physician
VA Connecticut Healthcare System
Topic
The STAMP Trial: Increasing Engagement in Advance Care Planning and Lessons Learned from Partnering with Community Ambulatory Practices
Keywords
STAMP Trial; Advance Care Planning; ACP; Patient engagement; Cluster randomized trial
Key Points
- The STAMP (Sharing and Talking about My Preferences) Trial is a cluster randomized controlled trial aimed at increasing engagement in Advanced Care Planning (ACP).
- The STAMP Trial first aimed to re-conceptualize advance care planning (ACP) to achieve the ultimate goal of enabling the patient or surrogate to make decisions in a future moment rather than making decisions in advance. In this way, ACP is a flexible act of communication that allows for in-the-moment advice of a patients care providers about the nuances of a particular clinical situation.
- ACP is a Health Behavior that involves stages of change. The STAMP Trial uses a 10 minute survey to assess how ready a patient is to start the ACP communication process.
- Patients are given ACP materials based on their stage of readiness as assessed by the survey.
- Results showed a small increase in ACP planning for groups randomized to the study interventions, but that small increase applied over large numbers of patients could have a significant impact on the number of people participating in ACP.
Discussion Themes
Cluster randomized trial design is complex unless you are working with an intervention that is implemented in a whole health care system rather than individual patients.
Determining a denominator in a cluster randomized trial at the patient level was very difficult.
Read more about Dr. Fried’s work on the STAMP Trial.
Tags
#pctGR, @Collaboratory1